Complications of cryosurgical ablation of the prostate to treat localized adenocarcinoma of the prostate.

OBJECTIVES: To review the complications associated with cryosurgical ablation of the prostate (CSAP) for localized adenocarcinoma of the prostate in the first 69 procedures performed at our institution.

METHODS: A retrospective review of the charts of 63 patients (69 procedures) performed at our institution between June, 1993, and December, 1994, was undertaken with an emphasis on the complications, their management, and outcome.

RESULTS: Thirty-seven of the 63 patients (59%) had at least one significant adverse event. Although no patient died or required a transfusion, other significant complications, including prolonged urinary retention, incontinence, sloughing of prostatic tissue, fistula formation, prolonged perineal pain, bowel dysfunction, and other problems were observed.

CONCLUSIONS: CSAP is associated with a significant complication rate. These complications are more common in patients who have had prior CSAP or radiation therapy. Instead of decreasing with experience, the complication rate increased later in the series. In our patients, the complication rate increased after the use of an investigational urethral warmer was discontinued. CSAP is an investigational procedure of unproved long-term efficacy. It can be associated with substantial patient morbidity and should be performed under carefully controlled circumstances. Patients should be made aware of the potential for debilitating complications.